[Necrosectomy and retroperitoneal lavage in necrotic pancreatitis]

Necrotic pancreatitis is the most severe of all acute pancreatitis and treatment with various surgical procedures has had a high mortality. A retrospective study of 37 patients treated by necrosectomy and postoperative lavage-drainage from January 1987 to December 1990 was made. The most frequent etiologies were alcoholic (21 patients) and biliary (15 patients). Eight patients had moderate pancreatitis according to Ranson's classification when they entered the hospital (one died) and in 28 it was severe (eight died). The mean time between entrance to the hospital and surgery was 15.1 days. Twenty five were reoperated, twelve for residual abscesses and eight of these died. The mean hospitalization time was 56.7 (+/- 32.8) days and overall mortality was 24.3%, smaller than that observed in our hospital with other various procedures. It is concluded that necrosectomy and lavage-drainage is a good surgical alternative for patients with necrotic pancreatitis.